Hormone Hoopla: Movers and Shakers of Diabetes (Part 1)


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There are so many facets to diabetes, from glucose to A1C[1] to lipids to hormones. What do hormones have to do with diabetes? As it turns out, quite a bit. Is it crucial that you understand all the different pieces of the diabetes puzzle? Maybe not, but since I know the most of you are keenly attuned to your diabetes, you might find this week’s posting of interest (at least, I hope you do!).

What the Heck Are Hormones, Anyway?
According to the National Institutes of Health (NIH), hormones are “your body’s chemical messengers.” Hormones travel in your blood and target specific organs or tissues, and they’re involved in a whole bunch of things, ranging from growth and development to reproduction to metabolism and even to mood. The word “hormone” comes from a Greek word that means “to spur on.” Hormones are given as medicine (think insulin injections, thyroid hormone, estrogen replacement) when the body’s own production goes awry.

The endocrine glands make hormones, which are actually types of protein. Endocrine glands include the pancreas, the adrenal glands, the thyroid, the thymus, ovaries, testes, and the pituitary and pineal glands. Even the gastrointestinal system is an endocrine gland, in some ways. The brain sends the signal to the endocrine glands to release hormones, which then seek out target cells. Target cells have receptors on them, which allow the hormone to work its magic, such as activating a gene or producing energy, for example. I like to think of hormones as “movers and shakers” because they make things happen in the body.

Diabetes-Related Hormones
The body produces many different kinds of hormones, and you certainly don’t need to know about all of them. Some hormones you’re probably already familiar with, such as estrogen, testosterone, growth hormone, and adrenalin, just to name a few. Some hormones are specifically or indirectly related to diabetes, so here’s a partial run-down:

Insulin. But of course! Insulin is made in the beta cells[2] of the pancreas. It’s released in response to an increase in blood glucose (typically after a meal is eaten). Most of the cells in the body have insulin receptors to which insulin binds. Once insulin hitches on, the cells allow glucose to enter to then be used for energy. The problem comes in with diabetes, when the pancreas either stops making insulin (or makes very little), as in the case of Type 1 diabetes[3], or when insulin cannot be used properly or the beta cells tucker out, as in the case of Type 2 diabetes[4].

Glucagon. Insulin’s counterpart is glucagon, a hormone made in the alpha cells of the pancreas. Glucagon works in the opposite manner of insulin, as it acts to raise blood glucose and help keep blood glucose levels steady between meals. When glucose levels drop too low, glucagon is released and it targets the liver, which is prompted to release some of its glucose stores to help bring blood glucose levels back up into a safe range.

Glucagon is available as an injection (by prescription), and is given when a person with diabetes is hypoglycemic and is unable to take glucose by mouth or is unconscious. The glucagon injection typically raises blood glucose within about 15 minutes. Glucagon injections are rarely needed for people with Type 2 diabetes, however.

Amylin. Lest you thought that insulin and glucagon were the only pancreatic hormones to contend with, along comes another one: amylin. Amylin was discovered in 1987 and it too has a role in diabetes management. Secreted by the beta cells along with insulin, amylin also works to lower blood glucose levels after a meal. Specifically, it promotes satiety (makes you feel full so you stop eating), suppresses the release of glucagon, and slows the rate at which food leaves the stomach.

Amylin is available as the prescription drug Symlin (pramlintide), and is available for people with Type 1 or Type 2 diabetes who inject insulin and who have difficulty managing blood glucose with insulin or insulin and diabetes pills. Symlin must be given by injection, generally before each meal. It cannot be mixed with insulin.

I’ll let you digest these hormones for this week, and next week, we’ll look at even more hormones that play a role in diabetes.

Endnotes:
  1. A1C: http://www.diabetesselfmanagement.com/articles/diabetes-definitions/HbA1c
  2. beta cells: http://www.diabetesselfmanagement.com/Articles/Diabetes-Definitions/beta_cells/
  3. Type 1 diabetes: http://www.diabetesselfmanagement.com/Articles/Diabetes-Definitions/type-1-diabetes/
  4. Type 2 diabetes: http://www.diabetesselfmanagement.com/Articles/Diabetes-Definitions/type-2-diabetes/

Source URL: https://www.diabetesselfmanagement.com/blog/hormone-hoopla-movers-and-shakers-of-diabetes-part-1/


Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin. Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.

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